摘要
目的观察丙泊酚、舒芬太尼、七氟烷在小儿腹腔镜疝囊高位结扎术中的麻醉效果及安全性。方法选择2020年5月至2022年5月,蒙城县中医院收治的小儿腹股沟疝患者88例,按照随机数表法分为对照组(丙泊酚-舒芬太尼)和观察组(丙泊酚-舒芬太尼复合七氟烷),各44例。比较2组患儿的围手术期指标、不同时间心率、动脉压、术后镇痛镇静效果及不良反应情况。结果观察组苏醒时间(8.67±2.89)min、住院时间(4.11±1.23)d均短于对照组(10.28±3.37)min、(4.54±1.15)d,差异有统计学意义(P<0.05)。2组麻醉诱导前、置入喉罩即刻、切皮时、术毕时的心率及动脉压均产生波动,观察组切皮时、术毕时的心率(95.26±5.14)次/min、(96.76±5.93)次/min,动脉压(80.07±3.35)mmHg、(80.29±3.22)mmHg均高于对照组(92.27±4.23)次/min、(94.14±5.29)次/min及(75.94±3.07)mmHg、(78.44±3.76)mmHg,差异有统计学意义(P<0.05)。2组苏醒期间儿童疼痛评分法(FLACC)最高评分差异无统计学意义(P>0.05)。2组入麻醉恢复室(PACU)即刻、入PACU后30 min、出PACU即刻的Ramsay镇静评分有显著变化,观察组出PACU即刻的Ramsay镇静评分(2.21±0.42)分低于对照组(2.48±0.66)分,差异有统计学意义(P<0.05)。观察组总不良反应发生率低于对照组(11.36%vs 29.55%),差异有统计学意义(P<0.05)。结论小儿腹腔镜疝囊高位结扎术中应用丙泊酚-舒芬太尼复合七氟烷进行麻醉可以缩短患儿苏醒时间和住院时间,维持心率及动脉压平稳,增加术后镇痛镇静效果,安全性良好。
Objective To observe the anesthetic effects and safety of propofol,sufentanil and sevoflurane during laparoscopic hernia sac high ligation in children.Methods This study included 88 children with inguinal hernia who were admitted to Mengcheng County Hospital of Traditional Chinese Medicine between May 2020 and May 2022.The subjects were randomly divided into the control group(44 children anesthetized with propofol and sufentanil)and the observation group(44 children anesthetized with propofol and sufentanil combined with sevoflurane).Heart rate,arterial pressure,postoperative analgesic and sedative effects,and adverse reactions in the two groups were comparatively analyzed.Results The recovery time and hospital stay of the observation group[(8.67±2.89)min,(4.11±1.23)d]were shorter than those of the control group[(10.28±3.37)min,(4.54±1.15)d](P<0.05).Heart rate and arterial pressure of the observation group at skin incision[(95.26±5.14)times/min and(80.07±3.35)mmHg]and the end of surgery[(96.76±5.93)times/min and(80.29±3.22)mmHg]were higher than those of the control group[(92.27±4.23)times/min and(75.94±3.07)mmHg,(94.14±5.29)times/min and(78.44±3.76)mmHg](P<0.05).The two groups had similar FLACC scores during recovery(P>0.05).Ramsay sedation scores of the two groups changed over time.The Ramsay sedation score of the observation group immediately after leaving the PACU was(2.21±0.42),lower than(2.48±0.66)of the control group(P<0.05).The incidence of total adverse reactions in the observation group was lower than that in the control group(11.36%vs 29.55%),and was significantly different(P<0.05).Conclusion Applying propofol and sufentanil combined with sevoflurane during laparoscopic hernia sac high ligation in children can shorten the recovery time and hospital stay,maintain stable heart rate and arterial pressure,improve postoperative analgesic and sedation effects,and have good safety.
作者
周顺
赵素侠
时静静
吴双双
吴圆圆
李金山
Zhou Shun;Zhao Suxia;Shi Jingjing;Wu Shuangshuang;Wu Yuanyuan;Li Jinshan(Department of Anesthesiology,Mengcheng County Hospital of Traditional Chinese Medicine,Bozhou,Anhui 233500,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2023年第5期603-607,共5页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
基金
安徽省医学会急诊临床研究项目(ky2018023)
关键词
儿童
疝
腹股沟
腹腔镜
麻醉
丙泊酚
舒芬太尼
七氟烷
疝囊高位结扎术
Children
Hernia,inguinal
Laparoscope
Anesthesia
Propofol
Sufentanil
Sevoflurane
Hernia sac high ligation
